Electronic cigarette-related exposures in young children from products such as vapes have increased 243 percent over the past eight years despite declining cigarette exposures, researchers found. The staggering figure comes from a new study published in JAMA Network Open from researchers at Rutgers New Jersey Medical School and the New Jersey Poison Control Center, who used National Poison Data System to analyze more than 92,000 reported nicotine exposures in children 5 and younger between 2016 and 2023. Researchers found tobacco exposures from conventional products such as cigarettes decreased by 43 percent.

The increase of exposures to electronic products such as vapes often involved children who inhaled the vapors directly from the devices, according to the study.

“When children see caregivers or older family members vaping, they may copy that behavior—bringing the device to their mouth and inhaling—without any understanding they are exposing themselves to a harmful substance,” said Diane Calello, executive and medical director of the New Jersey Poison Control Center.

The devices are often ready to use, brightly colors, and require little effort to activate, and appear more like toys than a harmful product, she said.

Children exposed to e-cigarettes were more likely to require a visit to a health care facility compared with those exposed to cigarettes. "This significant spike in children breathing in these substances tells us the risk has changed: It's no longer just about a toddler swallowing something they found on the floor," said Perry Rosen, the lead author who conducted the research at the New Jersey Poison Control. "Many recent cases involve children actively using e-cigarette devices after gaining access to them." Even just moderate ongoing exposure among users of vaping products has been associated with lasting health effects on developing lungs, including increased risk of bronchitis and worsening asthma, although these effects have not yet been reported in young children, according to researchers. The upward trend in childhood poisonings has continued despite federal laws passed in 2019 and 2020 to raise the minimum purchase age and restrict certain flavors. Liquid nicotine can only be sold in child-resistant containers under the New Jersey Liquid Nicotine Child-Resistant Container Act, but researchers warn that while this may prevent a child from swallowing the liquid, children may still be tempted to mimic the behavior they see in adults - including inhaling the nicotine. "Child-resistant packaging may prevent a toddler from swallowing liquid nicotine, but it does nothing to stop a child from copying what they see an adult do," Rosen said. "That's why we need safety standards that address the device itself, not just the container."